Preliminary evaluation of a primary care intervention for cry-fuss behaviours in the first 3-4 months of life (‘The Possums Approach’) : effects on cry-fuss behaviours and maternal mood

Problem crying in the first few months of life is both common and complex, arising out of multiple interacting and co-evolving factors. Parents whose babies cry and fuss a lot receive conflicting advice as they seek help from multiple health providers and emergency departments, and may be admitted into tertiary residential services. Conflicting advice is costly, and arises out of discipline-specific interpretations of evidence. An integrated, interdisciplinary primary care intervention (‘The Possums Approach’) for cry-fuss problems in the first months of life was developed from available peer-reviewed evidence. This study reports on preliminary evaluation of delivery of the intervention. A total of 20 mothers who had crying babies under 16 weeks of age (average age 6.15 weeks) completed questionnaires, including the Crying Patterns Questionnaire and the Edinburgh Postnatal Depression Scale, before and 3-4 weeks after their first consultation with trained primary care practitioners. Preliminary evaluation is promising. The Crying Patterns Questionnaire showed a significant decrease in crying and fussing duration, by 1 h in the evening (P = 0.001) and 30 min at night (P = 0.009). The median total amount of crying and fussing in a 24-h period was reduced from 6.12 to 3 h. The Edinburgh Postnatal Depression Scale showed a significant improvement in depressive symptoms, with the median score decreasing from 11 to 6 (P = 0.005). These findings are corroborated by an analysis of results for the subset of 16 participants whose babies were under 12 weeks of age (average age 4.71 weeks). These preliminary results demonstrate significantly decreased infant crying in the evening and during the night and improved maternal mood, validating an innovative interdisciplinary clinical intervention for cry-fuss problems in the first few months of life. This intervention, delivered by trained health professionals, has the potential to mitigate the costly problem of health professionals giving discipline-specific and conflicting advice post-birth.

Introducing solids and water to Australian infants

Background: Recommendations for the introduction of solids and fluids to an infant’s diet have changed over the past decade. Since these changes, there has been minimal research to determine patterns in the introduction of foods and fluids to infants. Methods: This retrospective cohort study surveyed mothers who birthed in Queensland, Australia, from February 1 to May 31, 2010, around 4 months postpartum. Frequencies of foods and fluids given to infants at 4, 8, 13, and 17 weeks were described. Logistic regression determined associations between infant feeding practices, the introduction of other foods and fluids at 17 weeks, and sociodemographic characteristics. Results: Response rate was 35.8%. At 17 weeks, 68% of infants were breastfed and 33% exclusively breastfed. Solids and water had been introduced in 8.6% and 35.0% of infants, respectively. The introduction of solids by 17 weeks was associated with younger maternal age and the infant being given water and infant formula at 4 weeks. The infant being given water at 17 weeks was associated with younger maternal age, the infant being given infant formula at 4 weeks, level of education, relative socioeconomic disadvantage, parity, and birth facility. Conclusion: Over the past decade, there has been a significant reduction in the proportion of infants in Australia who have been given solids by 17 weeks. Sociodemographic characteristics and formula feeding practices at 4 weeks were associated with the introduction of solids and water by 17 weeks. Further research should examine these barriers to improve compliance with current infant feeding recommendations.

Six theories of Neoliberalism

This paper takes as its starting point the observation that neoliberalism is a concept that is ‘oft-invoked but ill-defined’ (Mudge 2008: 703). It provides a taxonomy of uses of the term neoliberalism to include: (1) an all-purpose denunciatory category; (2) ‘the way things are’; (3) a particular institutional framework characterizing Anglo-American forms of national capitalism; (4) a dominant ideology of global capitalism; (5) a form of governmentality and hegemony; and (6) a variant within the broad framework of liberalism as both theory and policy discourse. It is argued that this sprawling set of definitions are not mutually compatible, and that uses of the term need to be dramatically narrowed from its current association with anything and everything that a particular author may find objectionable. In particular, it is argued that the uses of the term by Michel Foucault in his 1978-79 lectures, found in The Birth of Biopolitics (Foucault, 2008) are not particularly compatible with its more recent status as a variant of dominant ideology or hegemony theories.

Mapping quantitative trait loci in a wild population using linkage and linkage disequilibrium analyses

Historical information can be used, in addition to pedigree, traits and genotypes, to map quantitative trait locus (QTL) in general populations via maximum likelihood estimation of variance components. This analysis is known as linkage disequilibrium (LD) and linkage mapping, because it exploits both linkage in families and LD at the population level. The search for QTL in the wild population of Soay sheep on St. Kilda is a proof of principle. We analysed the data from a previous study and confirmed some of the QTLs reported. The most striking result was the confirmation of a QTL affecting birth weight that had been reported using association tests but not when using linkage-based analyses. Copyright © Cambridge University Press 2010.

Multipurpose identity-based signcryption : a Swiss army knife for identity-based cryptography

Identity-Based (IB) cryptography is a rapidly emerging approach to public-key cryptography that does not require principals to pre-compute key pairs and obtain certificates for their public keys— instead, public keys can be arbitrary identifiers such as email addresses, while private keys are derived at any time by a trusted private key generator upon request by the designated principals. Despite the flurry of recent results on IB encryption and signature, some questions regarding the security and efficiency of practicing IB encryption (IBE) and signature (IBS) as a joint IB signature/encryption (IBSE) scheme with a common set of parameters and keys, remain unanswered. We first propose a stringent security model for IBSE schemes. We require the usual strong security properties of: (for confidentiality) indistinguishability against adaptive chosen-ciphertext attacks, and (for nonrepudiation) existential unforgeability against chosen-message insider attacks. In addition, to ensure as strong as possible ciphertext armoring, we also ask (for anonymity) that authorship not be transmitted in the clear, and (for unlinkability) that it remain unverifiable by anyone except (for authentication) by the legitimate recipient alone. We then present an efficient IBSE construction, based on bilinear pairings, that satisfies all these security requirements, and yet is as compact as pairing-based IBE and IBS in isolation. Our scheme is secure, compact, fast and practical, offers detachable signatures, and supports multirecipient encryption with signature sharing for maximum scalability.

The moral status of babies

In their controversial paper 'After-birth abortion', Alberto Giubilini and Francesca Minerva argue that there is no rational basis for allowing abortion but prohibiting infanticide ('after-birth abortion'). We ought in all consistency either to allow both or prohibit both. This paper rejects their claim, arguing that much-neglected considerations in philosophical discussions of this issue are capable of explaining why we currently permit abortion in some cases, while prohibiting infanticide.

Microorganisms within human follicular fluid : effects on IVF

Our previous study reported microorganisms in human follicular fluid. The objective of this study was to test human follicular fluid for the presence of microorganisms and to correlate these findings with the in vitro fertilization (IVF) outcomes. In this study, 263 paired follicular fluids and vaginal swabs were collected from women undergoing IVF cycles, with various causes for infertility, and were cultured to detect microorganisms. The cause of infertility and the IVF outcomes for each woman were correlated with the microorganisms detected within follicular fluid collected at the time of trans-vaginal oocyte retrieval. Microorganisms isolated from follicular fluids were classified as: (1) ‘colonizers’ if microorganisms were detected within the follicular fluid, but not within the vaginal swab (at the time of oocyte retrieval); or (2) ‘contaminants’ if microorganisms detected in the vagina at the time of oocyte retrieval were also detected within the follicular fluid. The presence of Lactobacillus spp. in ovarian follicular fluids was associated with embryo maturation and transfer. This study revealed microorganisms in follicular fluid itself and that the presence of particular microorganisms has an adverse affect on IVF outcomes as seen by an overall decrease in embryo transfer rates and pregnancy rates in both fertile and infertile women, and live birth rates in women with idiopathic infertility. Follicular fluid microorganisms are a potential cause of adverse pregnancy outcomes in IVF in both infertile women and in fertile women with infertile male partners.

A cross-sectional analysis of patterns of obesity in a cohort of working nurses and midwives in Australia, New Zealand, and the United Kingdom

Objective The aim of this study was to examine the prevalence of overweight and obesity and the association with demographic, reproductive work variables in a representative cohort of working nurses and midwives. Design A cross sectional study of self reported survey data. Settings Australia, New Zealand and the United Kingdom. Methods Measurement outcomes included BMI categories, demographic (age, gender, marital status, ethnicity), reproductive (parity, number of births, mother's age at first birth, birth type and menopausal status) and workforce (registration council, employment type and principal specialty) variables. Participants 4996 respondents to the Nurses and Midwives e-Cohort study who were currently registered and working in nursing or midwifery in Australia (n=3144), New Zealand (n=778) or the United Kingdom (n=1074). Results Amongst the sample 61.87% were outside the healthy weight range and across all three jurisdictions the prevalence of obesity in nurses and midwives exceeded rates in the source populations by 1.73% up to 3.74%. Being overweight or obese was significantly associated with increasing age (35–44 yrs aOR 1.71, 95% CI 1.41–2.08; 45–55 yrs aOR 1.90, 95%CI 1.56–2.31; 55–64 aOR 2.22, 95% CI 1.71–2.88), and male gender (aOR 1.46, 95% CI 1.15–1.87). Primiparous nurses and midwives were more likely to be overweight or obese (aOR 1.37, 95% CI 1.06–1.76) as were those who had reached menopause (aOR 1.37, 95% CI 1.11–1.69). Nurses and midwives in part-time or casual employment had significantly reduced risk of being overweight or obese, (aOR 0.81, 95% CI 0.70–0.94 and aOR 0.75, 95% CI 0.59–0.96 respectively), whilst working in aged carried increased risk (aOR 1.37, 95% CI 1.04–1.80). Conclusion Nurses and midwives in this study have higher prevalence of obesity and overweight than the general population and those who are older, male, or female primiparous and menopausal have significantly higher risk of overweight or obesity as do those working fulltime, or in aged care. The consequences of overweight and obesity in this occupational group may impact on their workforce participation, their management of overweight and obese patients in their care as well as influencing their individual health behaviours and risks of occupational injury and chronic disease.

Evaluation of primary epidermal lamellar density in the forefeet of near-term fetal Australian feral and domesticated horses

Objective: To investigate the density of the primary epidermal lamellae (PEL) around the solar circumference of the forefeet of near-term fetal feral and nonferal (ie, domesticated) horses. Sample: Left forefeet from near-term Australian feral (n = 14) and domesticated (4) horse fetuses. Procedures: Near-term feral horse fetuses were obtained from culled mares within 10 minutes of death; fetuses that had died in utero 2 weeks prior to anticipated birth date and were delivered from live Thoroughbred mares were also obtained. Following disarticulation at the carpus, the left forefoot of each fetus was frozen during dissection and data collection. In a standard section of each hoof, the stratum internum PEL density was calculated at the midline center (12 o'clock) and the medial and lateral break-over points (11 and 1 o'clock), toe quarters (10 and 2 o'clock), and quarters (4 and 6 o'clock). Values for matching lateral and medial zones were averaged and expressed as 1 density. Density differences at the 4 locations between the feral and domesticated horse feet were assessed by use of imaging software analysis. Results: In fetal domesticated horse feet, PEL density did not differ among the 4 locations. In fetal feral horse feet, PEL density differed significantly among locations, with a pattern of gradual reduction from the dorsal to the palmar aspect of the foot. The PEL density distribution differed significantly between fetal domesticated and feral horse feet. Conclusions and Clinical Relevance: Results indicated that PEL density distribution differs between fetal feral and domesticated horse feet, suggestive of an adaptation of feral horses to environment challenges.

Mid-gestation intra-amniotic infection with Ureaplasma parvum is resolved within spiny mice (Acomys cahirinus) by term delivery: but caused chronic infection of fetal lungs and placentae

Background: Ureaplasma species in amniotic fluid at the time of second-trimester amniocentesis increases the risk of preterm birth, but most affected pregnancies continue to term (Gerber et al. J Infect Dis 2003). We aimed to model intra-amniotic (IA) ureaplasma infection in spiny mice, a species with a relatively long gestation (39 days) that allows investigation of the disposition and possible clearance of ureaplasmas in the feto-placental compartment. Method: Pregnant spiny mice received IA injections of U. parvum serovar 6 (10µL, 1x104 colony-forming-units in PBS) or 10B media (10µL; control) at 20 days (d) of gestation (term=39d). At 37d fetuses (n=3 ureaplasma, n=4 control) were surgically delivered and tissues were collected for; bacterial culture, ureaplasma mba and urease gene expression by PCR, tissue WBC counts and indirect fluorescent antibody (IFA) staining using anti-ureaplasma serovar 6 (rabbit) antiserum. Maternal and fetal plasma IgG was measured by Western blot. Results: Ureaplasmas were not detected by culture or PCR in fetal or maternal tissues but were visualized by IFA within placental and fetal lung tissues, in association with inflammatory changes and elevated WBC counts (p<0.0001). Anti-ureaplasma IgG was detected in maternal (2/2 tested) and fetal (1/2 tested) plasma but not in controls (0/3). Conclusions: IA injection of ureaplasmas in mid-gestation spiny mice caused persistent fetal lung and placental infection even though ureaplasmas were undetectable using standard culture or PCR techniques. This is consistent with resolution of IA infection, which may occur in human pregnancies that continue to term despite detection of ureaplasmas in mid-gestation.

Ureaplasma species multiple banded antigen (MBA) variation is associated with the severity of chorioamnionitis in late preterm placentas

Background: Intra-amniotic infection accounts for 30% of all preterm births (PTB), with the human Ureaplasma species being the most frequently identified microorganism from the placentas of women who deliver preterm. The highest prevalence of PTB occurs late preterm (32-36 weeks) but no studies have investigated the role of infectious aetiologies associated with late preterm birth. Method: Placentas from women with late PTB were dissected aseptically and samples of chorioamnion tissue and membrane swabs were collected. These were tested for Ureaplasma spp. and aerobic/anaerobic bacteria by culture and real-time PCR. Western blot was used to assess MBA variation in ureaplasma clinical isolates. The presence of microorganisms was correlated with histological chorioamnionitis. Results: Ureaplasma spp. were isolated from 33/466 (7%) of placentas by culture or PCR. The presence of ureaplasmas, but not other microorganisms, was associated with histological chorioamnionitis (21/33 ureaplasma-positive vs. 8/42 other bacteria; p= 0.001). Ureaplasma clinical isolates demonstrating no MBA variation were associated with histological chorioamnionitis. By contrast, ureaplasmas displaying MBA variation were isolated from placentas with no significant histological chorioamnionitis (p= 0.001). Conclusion: Ureaplasma spp. within placentas delivered late preterm (7%) is associated with histological chorioamnionitis (p = 0.001). Decreased inflammation within chorioamnion was observed when the clinical ureaplasma isolates demonstrated variation of their surface-exposed lipoproteins (MBA). This variation may be a mechanism by which ureaplasmas modulate and evade the host immune response. So whilst ureaplasmas are present intra-amniotically they are not suspected because of the normal macroscopic appearance of the placentas and the amniotic fluid.

Alteration of the foetal skin's response to Lipopolysaccharide (LPS) following Ureplasma Parvum exposure

Early preterm birth (<32 weeks) is associated with in utero infection and inflammation. We used an ovine model of in utero infection to ask if exposure to Ureaplasma serovar 3 (UP) modulated the response of the fetal skin to LPS.

Foetal skin inflammation in response to in utero Ureaplasma Parvum exposure

Early preterm birth (<32 weeks) is associated with in utero infection and inflammation. We used an ovine model of in utero infection to ask if exposure to Ureaplasma serovar 3 (UP) modulated the response of the fetal skin to LPS.

Working for a better life : longitudinal evidence on the predictors of employment among recently arrived refugee migrant men living in Australia

Although a number of studies have investigated the predictors of employment among refugee migrants, there is a dearth of evidence from longitudinal data. This study investigated the cross-sectional and longitudinal predictors of employment among 233 adult refugee men living in South-East Queensland, Australia. Participants were interviewed four times at six-month intervals between 2008 and 2010. Using a conceptual model developed from the literature, Generalised Estimating Equations were used to model the predictors of employment. Over time, the employment rate increased from 44 percent to 56 percent. Region of birth, length of time in Australia, seeking employment through job service providers and informal networks, and owning a car were significant predictors of employment. Contrary to previous research, English language proficiency was not a significant predictor when other variables were controlled for. Recognition of overseas skills and qualifications decreased the chances of finding employment. The policy and program implications are discussed.

Conflict and communication among engineers

The trend of cultural diversity is increasing in all organizations, especially engineering ones, due to globalization, mergers, joint ventures and the movement of the workforce. The collaborative nature of projects in engineering industries requires long-term teamwork between local and international engineers. Research confirms a specific culture among engineering companies that isassumed to have a negative effect on collaboration and communication among co-workers. Multicultural workplaces have been reported as challenging environments in the engineering work culture, which calls for more research among engineering organizations. An everyday challenge for co-workers, especially in culturally diverse contexts, is handling interpersonal conflict. This perceived conflict among individuals can happen because of actual differences in tasks or relationships. Research demonstrates that task conflict at the group level has some positive effects on decision-making and innovation, while it has negative effects on employees’ work attitude and performance. However, relationship conflict at the individual level has only negative effects including frustration, tension, low job satisfaction, high employee turnover and low productivity. Outcomes of both task and relationship conflict at individual level can have long-term negative consequences like damaged organizational commitment. One of the most important sources of differences between individuals, which results in conflict, is their cultural backgrounds. First, this thesis suggests that in culturally diverse workplaces, people perceive more relationship conflict than task conflict. Second, this thesis examines interpersonal communication in culturally diverse work places. Communicating effectively in culturally diverse workplaces is crucial for today’s business. Culture has a large effect on the ways that people communicate with each other. Ineffective communication can escalate interpersonal conflict and cause frustration in the long term. Communication satisfaction, defined as enjoying the communication and feeling that the communication was appropriate and effective, has a positive effect on individuals’ psychological wellbeing. In a culturally diverse workplace, it is assumed that individuals feel less satisfied with their interpersonal communications because of their lack of knowledge about other cultures’ communication norms. To manage interpersonal interactions, many authors suggest that individuals need a specific capability, i.e., cultural intelligence (some studies use cultural competence, global intelligence or intercultural competence interchangeably). Some authors argue that cultures are synergic and convergent and the postmodernist definition of culture is just our dominant beliefs. However, other authors suggest that cultural intelligence is the strongest and most comprehensive competency for managing cross-cultural interactions, because various cultures differ so greatly at the micro level. This thesis argues that individuals with a high level of cultural intelligence perceive less interpersonal conflict and more satisfaction with their interpersonal communication. Third, this thesis also looks at individuals' perception of cultural diversity. It is suggested that level of cultural diversity plays a moderating role on all of the proposed relationships (effect of cultural intelligence on perception of relationship conflict/ communication satisfaction) This thesis examines the relationship among cultural diversity, cultural intelligence, interpersonal conflict and communication by surveying eleven companies in the oil and gas industry. The multicultural nature of companies within the oil and gas industry and the characteristics of engineering culture call for more in-depth research on interpersonal interactions. A total of 286 invitation emails were sent and 118 respondents replied to the survey, giving a 41.26 per cent response rate. All the respondents were engineers, engineering managers or practical technicians. The average age of the participants was 36.93 years and 58.82 per cent were male. Overall, 47.6 per cent of the respondents had at least a master’s degree. Totally, 42.85 per cent of the respondents were working in a country that was not their country of birth. The overall findings reveal that cultural diversity and cultural intelligence significantly influence interpersonal conflict and communication satisfaction. Further, this thesis also finds that cultural intelligence is an effective competency for dealing with the perception of interpersonal relationship conflict and communication satisfaction when the level of cultural diversity is moderate to high. This thesis suggests that cultural intelligence training is necessary to increase the level of this competency among employees in order to help them to have better understanding of other cultures. Human resource management can design these training courses with consideration for the level of cultural diversity within the organization.